<症例>慢性血液透析の経過中に解離性大動脈瘤を併発した一剖検例

概要

論文の詳細を見る
A 72-year-old man had received hemodialysis three times a week for two years. When the hemodialysis was started, he was found to have an aneurysm of the abdominal aorta. Before admission, 8 hours after hemodialysis the patient experienced severe epigastralgia and back pain. Dissecting aneurysm of the thoracic aorta was diagnosed by ultrasound study and CT scan of the chest. He was continuously treated by hemodialysis with analgesics for pain and hydralazine for controlled blood pressure (140-150mmHg in systolic) during three months after dissection. Around twenty minutes after beginning hemodialysis, the blood pressure rapidly fell to 80-90 mmHg in systolic. Regardless of the examination such as the change of circulation volume, by using hypersodium or bicarbonate dialysate and hemofiltration, the fall of blood pressure could not be regulated satisfactorily. During hemodialysis, however, the systolic blood pressure was maintained around 100 mmHg. Three months after an attack of dissecting aneurysm, the patient suffered a cardiac arrest due to the rupture of aneurysm. In the postmortem examination, a dissecting aneurysm which occurred with atherosclerosis, extended from 5 cm distal of the left subclavian artery to beneath the bilateral renal artery. The dissection was not connected with the abdominal aneurysm.
近畿大学の論文
1983-03-25